Many experienced SLPs use multiple methods and approaches rather than a “one approach fits all” notion, taking many of the ideas mentioned above and using them based on the individual child’s needs. There is no one “program” that is right for every child with apraxia of speech. Commercial products, programs, apps or kits can be great tools for use in therapy by an SLP who understands the nature of apraxia and how to treat it. However, such programs alone are not the solution. Excellent therapy for children with apraxia involves much more than an SLP buying a manual or app and doing activities in it. Your child’s SLP needs to know precisely what to work on and specifically how to do it based on your child’s particular needs and abilities. A packaged program, kit or an iPad app cannot do that kind of thinking! Only a skilled, “thinking” professional can apply their special knowledge and then use “tools” to work on goals that will help your child achieve intelligible speech.
Children with apraxia of speech reportedly do not progress well in their actual speech production with therapy tailored for other articulation problems or solely with language stimulation approaches. Additionally, in young children the speech motor/sensory techniques and repetitions of words and target phrases should be woven into play activities that are highly motivational to them. What experienced therapists and families report is that children with apraxia need frequent one-on-one therapy and lots of repetition of sound sequences, and speech movement patterns in order to incorporate them and make them automatic.
Parents and caregivers are critical to success for children with apraxia of speech. Parents should look to their child’s SLP as a coach, tutor and guide so that the practice they encourage at home is appropriate for their child’s current ability level. Children with apraxia need to gain confidence in the speech therapy process and in themselves. Appropriate speech therapy and home practice, woven with support and understanding, can go a long way to assist children to become “risk-takers” in their speech.
Many children benefit when provided with augmentative or alternative communication modes (AAC). AAC can be either “low tech”, such as pictures or sign language or can be “high tech” as is the case of an iPad app or another communication device. Sign language can also be used as a form of visual cueing for proper placement for the production of words. Children should work to pair their best spoken attempt with a sign so that the two get associated with one another. According to research, the proper and thoughtful use of AAC does not inhibit a child’s speech.
Finally, it is important for parents and others to understand that many children will have other needs, above and beyond the specific speech practice mentioned above. Many children will also need to work on using language, such as how to put sentences together appropriately; use verb tenses; word endings; and so forth. Some children may have some degree of difficulty understanding language and that will need addressed in speech therapy, in addition to the speech production practice that is needed for the apraxia part of their difficulty. Most children will need to learn conversational skills like turn-taking, staying on topic, giving eye contact, and other “pragmatic” skills. All of these areas would require their own approaches and are above and beyond what is needed to improve speech production. These other areas are very important to your child’s overall success in various settings. Be sure that your child’s SLP is planning for and addressing all areas in which your child needs speech, language, and communication help.
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